There has been only one other case of endoventricular circular patch plasty performed in conjunction with aortic valve replacement reported in the literature. We present the unique case of a patient suffering from congestive heart failure due to both post-infarct aortic regurgitation and ventricular aneurysm along with his successful surgical ...

Symptoms of bicuspid aortic valve usually occur in the age group of 50-70 years, but rarely, it can also lead to sudden unexpected death in infancy and early childhood. The autopsy of a 2-month-old baby boy, found dead in his cot, revealed the heart weight as 25 g, and the ...

We present a case of aortic dissection with shock due to cardiac tamponade in a previously healthy 15-year-old male. The diagnosis was suspected and confirmed by transthoracic echocardiography before transfer to the cardiothoracic unit for successful surgical intervention. Because it is a rare life-threatening condition with a high mortality rate ...

OBJECTIVES: To avoid prosthesis-patient mismatch, posterior enlargement of the small aortic annulus using the Nicks-Nunez surgical approach was performed in fifteen patients and the immediate-intermediate results are reported retrospectively. METHODS: During the period November 1995 to June 2005, 220 patients underwent aortic valve replacement (AVR) for primary aortic stenosis (AS). ...

OBJECTIVE: To evaluate the rapid ventricular pacing in balloon aortic valvuloplasty to achieve balloon stability. MATERIAL AND METHODS: From September 2004 to July 2005, a prospective protocol was carried out: ten patients with aortic valve stenosis were treated with this method. Patient's age ranged from 3 to 16 years with ...

Senile aortic stenosis is characterized by calcific degeneration of the valve that prevents the full opening of the cusps in systole. The disease may be silent for many years despite the presence of severe flow obstruction and generally is associated with aortic regurgitation and calcification of the coronary arteries. The ...

Patients with liver cirrhosis are prone to the development of severe complications associated with high mortality rates after major surgery, especially cardiac surgery using cardiopulmonary bypass (CPB). We report the case of a 65-year-old man with acute infective endocarditis and aortic valve perforation, complicated by non-cardiac liver cirrhosis (Child-Pugh class ...

Bicuspid aortic valve is a relatively common cause of congestive heart failure in young patients. In a young population, symptoms mnay not correlate with the severity of disease. We report a case of bicuspid aortic valve presenting with clinical features of unicuspid aortic valve, and mild symptoms despite severe hemodynamic ...

BACKGROUND: Currently, the optimal treatment of acute type B aortic dissection remains controversial. The purpose of this study was to report early clinical outcomes of medical management for acute type B aortic dissection. METHODS AND RESULTS: Between January 2001 and March 2005, 129 consecutive patients with the confirmed diagnosis of ...

BACKGROUND: Ischemic preconditioning (IP) is a cardioprotective phenomenon, induced by brief episodes of myocardial ischemia, which is supposed to affect not only the myocardium, but also the entire cardiovascular system. Considering that patients with coronary artery disease (CAD) have also been described to present impaired aortic mechanical properties, we tried ...

Acute aortic occlusion is an uncommon entity requiring prompt recognition and intervention to limit morbidity and mortality. We describe 2 patients with acute aortic occlusion who presented uniquely with sudden onset of paraplegia. In addition, we highlight their circuitous diagnostic course and the adverse impact of diagnostic delay in their ...

BACKGROUND: An increased extracellular matrix (ECM) turnover has been associated with poor survival in patients with chronic heart failure (CHF) due to dilated cardiomyopathy (DCM). However, the influence of the accelerated collagen turnover on the progressive large artery stiffening process characterizing CHF has not been clarified. This is relevant because ...

We report the case of a 74-year-old patient admitted for acute anterior myocardial infarction and treated by intravenous thrombolysis. Because of hemodynamic instability, an intra-aortic balloon pump (IABP) was inserted. However, the patient's systolic blood pressure deteriorated early after IABP placement. Echocardiography revealed a dynamic left ventricular outflow tract obstruction ...

Cardiac multidetector helical computed tomography angiogram (MDCTA) findings of a quadricuspid aortic valve are presented. MDCTA enabled evaluation of the aortic valve and its function, the coronary arteries, and left ventricular function. This case is, to our knowledge, the first description of the MDCTA imaging appearance of quadricuspid aortic valve.

Despite successful surgical repair, patients with congenital aortico-left ventricular tunnel (ALVT) are at risk of developing aortic incompetence in the late postoperative period. Two cases of ALVT were followed for 10 years with special reference to aortic incompetence and geometry of the aortic root. The patients underwent repair of ALVT, ...

Patients with mechanical aortic valves that develop refractory heart failure may require left ventricular assist devices. These patients have an increased risk of postoperative thromboembolic events due to intermittent valve opening. Previously described techniques to address this problem can result in a significantly increased ischemic time. We describe a simple ...

INTRODUCTION: Clinical and laboratory data provide an increasing amount of information regarding the common aetiopathogenetic background of acquired heart defects with calcification and arterial atherosclerosis. AIM: To evaluate the relationship between presence and severity of calcifications of the aortic semilunar valves and the intensity of atherosclerotic lesions in the aorta ...

BACKGROUND & AIMS: Glutamate plays an important role for myocardial metabolism in association with ischaemia. Patients with coronary artery disease characteristically demonstrate increased uptake of glutamate. Improved recovery of myocardial metabolism and haemodynamic state after coronary surgery has been reported in patients treated with glutamate infusion. However, the effect of ...

It has been reported that 30-40% of patients with aortic stenosis are hypertensive. In such patients, the left ventricle faces a double (i.e. valvular and vascular) pressure overload, which results in subsequent wall volume hypertrophy. From a clinical standpoint, it is difficult to separate the respective contributions of aortic stenosis ...

We report a case of Stanford type A acute aortic dissection caused by blunt trauma in a patient with situs inversus. A 57-year-old man was involved in an explosion accident. It was indicated that he had suffered Stanford type A acute aortic dissection, cardiac tamponade, and situs inversus by contrast ...

PURPOSE: Normally, the aortic arch and the descending aorta are not visible using transthoracic ultrasonography. We hypothesize that lung consolidation of upper and lower lobes, by opening an acoustic window, may allow the ultrasound examination of the thoracic aorta. METHODS: During a 2-month period, 18 consecutive patients hospitalized in the ...

Interrupted aortic arch (IAA) is a rare severe congenital heart defect defined as a complete loss of luminal and anatomic continuity between ascending and descending aorta. It is important that we made a good diagnosis and accurate evaluation of their morphologic conditions before a heart operation. We presented an 18-year-old ...

Damus-Kaye-Stansel procedure is a useful method to relieve the systemic ventricular outflow tract obstruction in functionally univentricular heart. Regurgitation of pulmonary valve and recurrence of systemic ventricular outflow obstruction are the major concerns at the late phase of this procedure. Modification of original Damus-Kaye-Stansel procedure that can prevent the use ...

OBJECTIVES: Although patients with aortic stenosis, who receive 19-mm valves, are at high risk for prosthesis-patient mismatch, most of them show a significant left ventricular mass (LVM) regression postoperatively. The aim of this study was to identify factors predicting postoperative relative LVM regression in this subgroup of patients. METHODS: A ...

A patient on hemodialysis with severe aortic valve disease and presumed arteriovenous fistula infection was found to have new-onset atrial fibrillation and alternating left and right bundle branch block patterns on serial electrocardiograms. These findings prompted transesophageal echocardiography, which revealed a large abscess involving the intervalvular fibrosa and the posterior ...

BACKGROUND AND AIM OF THE STUDY: Aortic stenosis (AS) is a common clinical problem which frequently necessitates aortic valve replacement (AVR). The traditional view of progressive AS is a 1:1 inverse relationship between valve calcium content and aortic valve area (AVA). However, this assumption has been based on subjective estimates ...

This study has been conducted in an effort to establish metabolic and inflammatory responses of the myocardium during aortic valve surgery on the beating heart with CPB and continuous coronary sinus perfusion with normothermic blood. Twenty patients, divided into two groups, participated in this study. Conventional aortic valvular operations were ...

OBJECTIVE: The effect of prosthesis-patient mismatch on clinical outcome and left ventricular mass regression after aortic valve replacement remains controversial. Data on whether the clinical effect of prosthesis-patient mismatch depends on left ventricular function at the time of aortic valve replacement are lacking. This study examined the long-term clinical and ...

BACKGROUND: Risk factors for postoperative heart failure (PHF) have not been specifically studied in valve surgery although it has been acknowledged that patient variables may have a more profound influence on postoperative outcome than valve-related factors. METHODS: All patients undergoing isolated aortic valve replacement for aortic stenosis from January 1995 ...

The technique of aortic root reconstruction with sparing of the native aortic valve has been adopted in patients with dilatation or dissection of the aortic root and normal, functional aortic valve leaflets. We report two patients who developed an unusual complication of this surgical procedure: a left ventricular outflow tract ...

This study was designed to evaluate the effect of cryopreservation on the glycosaminoglycan (GAG) content of the aortic allografts. Twenty-one porcine aortic valves were obtained. Five aortic roots were immediately analyzed without cryopreservation, eight were cryopreserved in closed leaflet position, and eight in open leaflet position. The groups were compared ...

BACKGROUND: Long-term left ventricular assist device (LVAD) support diminishes flow through the native aortic valve and decreases valve motion. This may cause aortic valve commissural fusion. The clinical importance of such fusion is not well understood. METHODS: Thirty-three consecutive patients receiving long-term LVAD support were followed up until transplantation or ...

BACKGROUND: N-acetylcysteine (NAC) is an antioxidant drug largely tested in different clinical situations. Recently, NAC has been employed with variable success in the prevention of radiocontrast nephropathy. Since aortic aneurysm surgical repair is a condition that is frequently accompanied by acute renal failure (ARF), we sought to investigate whether NAC ...

We present two transesophageal echocardiographic images of a patient with acute myocardial infarction, demonstrating a large thrombus attached to the thoracic aortic wall, considered to be a complication of intra-aortic balloon pumping. The patient had received the device because of hemodynamic instability due to an infarct-related ventricular septal defect. Clinical ...

Aortic stenosis is the most common valvular abnormality in the United States today. It has been well established that most patients with severe symptomatic aortic stenosis should undergo operation with aortic valve replacement. This is particularly true when ventricular function is maintained, as the operative risk is low and the ...

Severe symptomatic aortic stenosis (AS) is an indication for surgical replacement of the aortic valve in adults. Patients are often affected by comorbidities, and the surgical indication is sometimes problematic. Non-surgical techniques have been developed during the past few years, though their roles have not yet been established. Cardiac resynchronization ...

Two competitive soccer players aged 23 and 17 years with known bicuspid aortic valve presented for sports-medical pre-participation screening. Both athletes were well trained and had a maximal oxygen uptake of 61 and 60 ml/min/kg, respectively. Echocardiography of the first athlete revealed an eccentric hypertrophy of the left ventricle (end-diastolic ...

We present a case of a patient presenting with a myocardial infarction with subsequent coronary intervention resulting in a coronary dissection complicated by an aortic dissection. The coronary dissection was treated with coronary stents. Transesophageal echocardiogram visualized the intracoronary stent within the intimal flap of the aortic dissection. The aortic ...

BACKGROUND: The natural history of aortic valve disease associated with ventricular dysfunction is dismal. Aortic valve replacement (AVR) is associated with increased mortality in patients with left ventricular dysfunction and the long-term outcome in these patients is not well-known. We evaluated perioperative outcomes and long-term results in patients with impaired ...

Aortic valve replacement in patients suffering from low-gradient aortic stenosis and congestive heart failure is associated with high operative mortality, and the perioperative use of inotropes is common. Levosimendan is a calcium sensitizer with positive inotropic and vasodilatory effects and has been developed for treatment of decompensated heart failure. Although ...

BACKGROUND: A new echocardiographic severity index of aortic valve stenosis has been recently introduced: the ejection fraction-velocity ratio (EFVR), which is a simple ratio ejection fraction/4Vmax2. This nonflow corrected index demonstrated an excellent accuracy in quantifying the effective orifice area (EOA) in native aortic valves. There is no information about ...

BACKGROUND AND OBJECTIVE: To investigate the effects of intra-aortic balloon pump therapy on parameters of global and regional oxygenation in patients undergoing cardiac surgery. METHODS: As part of a large surveillance study in cardiac surgery patients (n=266) we retrospectively analyzed the course of 28 patients requiring intra-aortic balloon pump therapy. ...

Epidemiologic studies have shown associations between impaired fetal growth and risk for coronary heart disease in adults. The underlying mechanisms are unknown. We investigated whether restricted intrauterine growth affects cardiac structure. We performed echocardiography on 216 9-year-old children who were measured previously at birth. The diameter of the coronary left ...

OBJECTIVE: After aortic valve replacement, the effects of a small functional prosthesis on the extent and pattern of regression of left ventricular hypertrophy and on clinical outcomes may be less significant in older patients with low cardiac output requirements. The objective of this study was therefore to determine whether patient-prosthesis ...

BACKGROUND: Prosthesis-patient mismatch (PPM) occurs when the effective orifice area (EOA) of the prosthesis being implanted is too small in relation to body size, thus causing abnormally high transvalvular pressure gradients. The objective of this study was to examine the midterm impact of PPM on overall mortality and cardiac events ...